Repairing an abdominal aortic aneurysm; stent grafts

Many patients who need surgery to repair an abdominal aortic aneurysm are recovering much faster and experiencing much less pain because of a relatively new grafting procedure performed at Methodist Medical Center of Oak Ridge.

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By Special to The Oak Ridger

Oakridger - Oak Ridge, TN

By Special to The Oak Ridger

Posted Jan. 26, 2013 at 3:00 PM
Updated Jan 26, 2013 at 3:04 PM

By Special to The Oak Ridger

Posted Jan. 26, 2013 at 3:00 PM
Updated Jan 26, 2013 at 3:04 PM

OAK RIDGE

Many patients who need surgery to repair an abdominal aortic aneurysm are recovering much faster and experiencing much less pain because of a relatively new grafting procedure performed at Methodist Medical Center of Oak Ridge.

“Surgeons are able to repair the largest artery in the body through small incisions, and most patients go home after an overnight stay in the hospital,” said Joseph Metcalf, IV, M.D., a board-certified surgeon on Methodist’s medical staff.

“During the procedure, a surgeon makes two incisions in the groin and inserts a catheter that contains an endovascular stent graft. He or she then places the graft, which is made of fabric and wire mesh, inside the weakened part of the aorta to provide support and redirect the blood flow from the aneurysm to the graft,” Dr. Metcalf explained. “The surgeon uses real-time x-rays to make certain the graft is positioned correctly.”

Surgeons also can treat smaller aneurysms in arteries to the kidneys, legs, or other areas with a stent graft.

“The aorta is the largest artery in the body. It runs through the chest and carries oxygen-rich blood from the heart to the abdomen, pelvic area, and legs. When it reaches the abdomen, it is called the ‘abdominal aorta,’” Dr. Metcalf said. “Weakness in the artery wall can cause an aneurysm, or bulge, that may burst and result in serious internal bleeding or blood clots.”

More than 15,000 Americans die as the result of ruptured aneurysms of this type every year. Early diagnosis and treatment can prevent many deaths, he added.

Surgery to correct this condition was introduced approximately 50 years ago. The standard open procedure entails a very large incision that runs the length of the abdomen, which gives surgeons access to the weakened section of the aorta. Patients receive general anesthesia, stay in the intensive care unit for several days, experience considerable blood loss and pain, and are hospitalized from four days to two weeks.

“The decision about whether to perform the grafting procedure or traditional open surgery depends on a number of factors including the results of the patient’s arteriogram and ultrasound ordered before surgery,” Metcalf said. “An arteriogram is an x-ray of blood vessels, which become visible after the patient is injected with a contrast solution.”

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About Joseph Metcalf, IV, M.D.: He is a board-certified surgeon on the staff of Methodist Medical Center of Oak Ridge. He earned his medical degree from Emory University in Atlanta and completed a general surgery residency at the University of Mississippi in Jackson. He is a fellow of the American College of Surgeons and a member of the American Medical Association. Dr. Metcalf specializes in general and vascular surgery.